Provider Demographics
NPI:1306970082
Name:YOGEL CHENVEN AND GORBATIY MD PA
Entity type:Organization
Organization Name:YOGEL CHENVEN AND GORBATIY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:YOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-463-6408
Mailing Address - Street 1:2150 S ANDREWS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-3496
Mailing Address - Country:US
Mailing Address - Phone:954-463-6408
Mailing Address - Fax:954-463-1858
Practice Address - Street 1:2150 S ANDREWS AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-3496
Practice Address - Country:US
Practice Address - Phone:954-463-6408
Practice Address - Fax:954-463-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2677903-00Medicaid
FL0377015-00Medicaid
FL0471348-00Medicaid
FLH86398Medicare UPIN